Basic Information
Provider Information
NPI: 1831570100
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BAYER
FirstName: CHELSEA
MiddleName: ANN
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3621 S STATE ST
Address2: PROVIDER ENROLLMENT
City: ANN ARBOR
State: MI
PostalCode: 481081636
CountryCode: US
TelephoneNumber: 7346475299
FaxNumber:  
Practice Location
Address1: 380 PARKLAND PLZ
Address2:  
City: ANN ARBOR
State: MI
PostalCode: 481036201
CountryCode: US
TelephoneNumber: 7349987380
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/12/2015
LastUpdateDate: 11/19/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/19/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000X4301500435MIY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


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